Client Coaching Readiness SurveyRate Each Statement Name First Name Last Name Email Survey I am willing to see new perspectives Strongly Disagree Disagree Neutral Agree Strongly Agree I will show you who I really am Strongly Disagree Disagree Neutral Agree Strongly Agree I am accountable to myself Strongly Disagree Disagree Neutral Agree Strongly Agree I am able and OK with focusing on me Strongly Disagree Disagree Neutral Agree Strongly Agree I will let go of limiting beliefs Strongly Disagree Disagree Neutral Agree Strongly Agree I do ‘think outside the box’ Strongly Disagree Disagree Neutral Agree Strongly Agree I like to be responsible for my results Strongly Disagree Disagree Neutral Agree Strongly Agree I am willing to ask for what I want Strongly Disagree Disagree Neutral Agree Strongly Agree I am aware of what does not work for my learning Strongly Disagree Disagree Neutral Agree Strongly Agree I am willing to take some risk to learn and grow Strongly Disagree Disagree Neutral Agree Strongly Agree I am open to change Strongly Disagree Disagree Neutral Agree Strongly Agree I am willing to be transparent Strongly Disagree Disagree Neutral Agree Strongly Agree I will keep my word to you, my coach Strongly Disagree Disagree Neutral Agree Strongly Agree I will keep my word to you, my coach Strongly Disagree Disagree Neutral Agree Strongly Agree I do not let limitations stop me Strongly Disagree Disagree Neutral Agree Strongly Agree I know I always have choice Strongly Disagree Disagree Neutral Agree Strongly Agree I am a good partner Strongly Disagree Disagree Neutral Agree Strongly Agree I dare to dream to have what I want Strongly Disagree Disagree Neutral Agree Strongly Agree I courageously say what does not work Strongly Disagree Disagree Neutral Agree Strongly Agree I do confront what got me where I do not want to be Strongly Disagree Disagree Neutral Agree Strongly Agree Thank you!
